Provider Demographics
NPI:1881661239
Name:STEWART, ROBYN A (MD)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:A
Last Name:STEWART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:A80
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-0001
Mailing Address - Country:US
Mailing Address - Phone:216-444-6293
Mailing Address - Fax:216-445-4048
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:A80
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-444-6293
Practice Address - Fax:216-445-4048
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2007-00337208600000X
OH094586208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1563562Medicaid
OH3018746OtherMEDICAID PIN
OH1563562Medicaid